Ketamine Potpourri

Ketamine Potpourri

In our most recent journal club, we took a look at 3 articles focused on the use of ketamine in the Emergency Department. When treating pain with ketamine, does a rapid administration of ketamine result in more dysphoria? When used for RSI, is ketamine more hemodynamically stable than etomidate? When using ketamine for procedural sedation in adult patients, does pre-treatment with versed or haldol decrease clinically significant emergence agitation?

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Grand Rounds Recap 5.23.18

Grand Rounds Recap 5.23.18

This week’s Grand Rounds opened with Dr. Koehler leading small group discussions on the applications and limitations of VBGs. Dr. Bonomo expertly identified the correct test of choice and diagnosis in Dr. Spigner’s CPC. Dr. Soria then gave an interesting talk on the history behind naloxone as well as common uses. Finally, the Air Care team led a great hands-on procedure workshop!

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Crash and Burn Part 2 - Approach to the MVC Patient

Crash and Burn Part 2 - Approach to the MVC Patient

We’re back again this week to discuss more about the initial approach to the MVC patient in B-pod.  Last week we discussed occult bowel injury in the setting of blunt abdominal trauma.  In the second episode of this topic, Dr. Powell also highlights the importance of an appropriate pain medication selection upon discharge from the emergency department, citing the importance to consciously avoid cavalier prescription of potentially habit-forming pain medications.  But what kind of risk is involved when we send patients home with opioid prescriptions?  Are they destined to seek out more?

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Grand Rounds Recap 10.5.2016

Grand Rounds Recap 10.5.2016

This week we had a Grand Rounds jam packed with clinical knowledge. When was the last time you considered the differential diagnosis of an elevated troponin? It's not just ACS! Read on to learn more about thyroid storm, refractory Vfib and Vtach, lithium toxicity, inflammatory markers, and more. As well as a special clinical soapbox about how Ohio became the epicenter of the nation's heroin epidemic.

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The Urine Drug Screen - Know Thy Limitations

The Urine Drug Screen - Know Thy Limitations

We are all guilty of ordering them in the ED, but do we really know what we’re ordering?

The Implications of the Urine Drug Screen

1 literature review looked at 7 different retrospective studies describing a total of 1,405 patients and found the urine drug screen did not affect the management of any of these patients while in the emergency department.  However, the data from the UDS can affect a patient’s clinical care outside of the Emergency Department.  For example, if a patient requires psychiatric inpatient care, initial knowledge of drug abuse could affect this patient’s etiology of illness or rehabilitation plan.

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